Individual
MS. MIA CONCORDIA
Active
Individual
MS. MIA CONCORDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LW61076495
WA
1041C0700X
Clinical Social Worker
Primary
LW61076495
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165261
—
WA
Enumeration date
08/11/2015
Last updated
10/02/2024
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